Finding Fun Facts in Data Deluge
It isn't exactly news that hospital bills bear no relation to what products and services actually cost, or the amount that is paid.
What IS new is the pressure on the hospital industry to defend its pricing system. On Wednesday, the Obama administration released data showing how much each hospital charges for various types of treatment and contrasts that with how much Medicare actually pays for it.
This release of data in the name of transparency follows by just a few weeks an attention-getting major opus in Time magazine by Steven Brill called Bitter Pill: Why Medical Bills Are Killing Us.
Wednesday's data dump is best left to those who are a whiz with Excel spreadsheets and who have a lot of time on their hands. The Florida list alone exceeds 1,800 pages.
The Washington Post has made a user-friendly interactive version that shows how state hospitals on average compare in charges to the national average and to other states. Click on Florida and you'll quickly see that prices are above average in every category.
The Post also highlighted an odd pairing from Florida: Jackson Memorial and University of Miami hospitals, which are across the street from one another. In each of three categories it checked (two heart procedures and intestinal surgery), UM charged a lot more, up to twice as much.
But the amount that Medicare paid was far less, between about 15 percent and 40 percent of the amount of the bill. And Jackson received a higher Medicare payment in all three cases, which may reflect the policy of paying major teaching hospitals at a higher rate to help cover those costs.
But this is not a new exercise. In fact, in 1992 the then-St. Petersburg Times ran a whole series on this theme called "The 16,000 Percent Solution." The headline came from one of the items on a hospital bill, which had a markup on one item that was a staggering 16,000 percent of its retail price.
The series encouraged readers to send in their bills if they found problems. The bills arrived by the hundreds. The Times ran stories about how uninsured patients tried to fight the bills.
Only a snippet is available free these days on the Times' archive site:
"Sherri Howell of Seminole could have taken a deluxe, eight-week trip around the world for the price of jaw surgery and two days in the hospital.
"The $15,000 bill from St. Anthony's Hospital in St. Petersburg last year included some heavy-duty medical razmatazz, such as $1,660 for an MRI brain scan. But what really got to Howell were the mundane items.
"What she and other patients have discovered is that common items bring uncommon prices when they show up on a hospital bill. ..."
The $15,000 charge for surgery and two days in the hospital now seems as outdated as a nickel Coke. But the principle remains news in 2013.
In 1992, hospital officials asked to defend their bills pushed them aside, saying they didn't matter since no one really paid those prices anyway. That isn't the same as saying no one was charged those prices. Those who lacked health insurance were charged the retail rate.
That has changed. As NPR reports, there's a provision in the Affordable Care Act that's supposed to prevent hospitals from charging most uninsured people the inflated rate.
But maybe this go-round, with national attention focused on it, hospitals may be willing to change the system. As Politico reported on Thursday, the American Hospital Association issued a statement saying the billing policies "urgently need updating."